Declaration of Last Supply

Form ID

F7-74662

Publication date

2023-11-20

Certificate

Anax Inc.

A supplier of services or materials to an improvement being made to:

1080 - 1115 Douglas McCurdy Common, Mississauga, ON

declares that:

1. The following services or materials were supplied:

Roofing

2. These services or materials were supplied under a contract (or subcontract) with:

Kingsmen (Lakeshore) Inc.

dated the

November 1, 2021

3. The last supply of services or materials made by the supplier to the improvement under contract (or subcontract) was made on:

April 25, 2023

4. No further services or materials will be supplied under the contract (or subcontract).

Declared before me at the:

City of

City

on the

15th day of November, 2023

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